Table 1. A summary of examined studies
Reference
Country, City
Year of Purpose of the study
Sample
Findings
study
PREVALENCE OF ALCOHOL CONSUMPTION DURING PREGNANCY AND THE CLINICAL COMPLICATIONS OF ALCOHOL-EXPOSED
PREGNANCIES(n=18)
a) Prevalence (11)
Balachova et Russia, SPB
2004To examine drinking
648 PW and non89% of non-PW reported consuming alcohol and 65% reported binge drinking
al., 2012a (in and NNR
2005
patterns among
pregnant childbearingin the past 3 months; 47% in NNR and 28% in SPB reported binges at least
English)
pregnant and non-PW age W from W’s
monthly. W who might become pregnant consumed alcohol similarly to W who
of childbearing age in clinics.
were not likely to become pregnant, and 32% of W in SPB and 54% in NNR
Russia.
were categorized as at risk for prenatal alcohol exposure. After pregnancy
recognition, fewer W drank. 20% of PW reported consuming alcohol and 6% in
SBP (none in NNR) reported binge drinking; however, a high prevalence of
binge drinking was found among W who might become pregnant or who were
trying to conceive.
Chambers et Russia,
2005
To describe patterns
413 W who were
347 (85%) reported some alcohol consumption during one of the two time
al., 2006 (in
Moscow
of alcohol
attending Ladies’
periods and 193 (51.9%) of these drinking W reported some alcohol use in the
English)
consumption and
Consultation clinics.
most recent month. Also, 75 (20.2%) of drinking W reported at least one
risky drinking among
episode of five or more drinks around the time of conception and 153 (41.1%)
PW in the Moscow
of drinking W reported at least one episode of three or four drinks during that
Region.
same time period.
Egorova et
Russia,
2001To examine the
95 PW with
15.8% of W with pancreatic and biliary system disorders abuse alcohol
al., 2012 (in
Krasnoyarsk
2010
reproductive health of pancreas/liver diseases, during pregnancy, while only 2.1% in the group of healthy W do so.
Russian)
W with pancreatic
71 non-PW with
and biliary system
pancreas/liver diseases,
disorders.
and 94 healthy PW.
Gaidukov et
Russia, SPB
2007
To determine the
270 W from maternity
82.4% of W consumed alcohol before pregnancy, and 13.7% during pregnancy.
al., 2008 (in
prevalence of alcohol welfare centers, and
82.9% of W stopped drinking at the beginning of their pregnancy. W aged 25Russian)
consumption in
maternal hospitals.
29 were more likely to consume alcohol before pregnancy. Before pregnancy, a
Russian W before and
positive link between prevalence of W's alcohol consumption and their socioafter pregnancy and
economic status was recorded. During pregnancy, none of the socio-economic
related sociofactors were related to prevalence of alcohol use.
demographic factors.
Kosyh et al., Russia, SPB
2004To measure the
155 PW (ages 18-44).
During the 3 months before pregnancy 50% of W consumed 7+ alcoholic
2010 (in
2005
prevalence of alcohol
drinks per week and 4+ drinks on a single occasion. During pregnancy, drinking
English)
consumption for W
rates were found to be lower than during the 3 months prior to pregnancy. No W
during the 3 months
were found to drink 7+ drinks per week or binge drink; however, 1 to 3 drinks
before
per week were still imbibed by 23.5 % of PW.
pregnancy/during
pregnancy.
Kristjanson
Russia, SPB
1999To measure the
899 PW.
Nearly all (95.9%) PW drank in the year before they became pregnant; of these,
et al., 2007
2000
prevalence and
60.0% reported drinking when they knew they were pregnant, and 34.9% drank
(in English)
drinking patterns
in the past 30 days. Among PW who drank in the past 30 days, 7.4% reporting
1
Reference
Country, City
Year of
study
Kurianova,
2006
Kurianova et
al., 2006 (2
publications;
in Russian)
Radzinsky,
2002 (in
Russian)
Russia,
Astrakhan
not
reported
Russia,
Moscow
not
reported
Sashchenko,
2007 (in
Russian)
Russia,
Moscow
not
reported
Shilko et al.,
2011a (in
Russian)
Russia,
Yekaterinburg
Talykova et
al., 2007 (in
English)
Russia,
Mončegorsk
and Apatity
b) Clinical Complications (7)
Alekseeva,
Russia,
2011a,b;
Yakutsk
Alekseeva
and Ivanova,
2011 (3
publications;
in Russian)
Purpose of the study
among PW and nonPW.
To analyze the health
status of W who were
consuming alcohol
during pregnancy.
Sample
Findings
having 5 or more drinks on at least 1 occasion.
100 W from the
postnatal unit of the
city's maternity
hospital.
83% of W consumed alcohol during pregnancy: 28% during the 1st half of their
pregnancy, 55% during the second half, and 18% during their entire pregnancy.
Alcohol was consumed due to traditional holidays (61%), birthdays (32%), no
reason (4%), and in company with friends (3%). The W preferred red or
sparkling wine, beer, and vodka.
To assess maternal
alcohol consumption
levels during
pregnancy.
To study the
pathogenesis of
gestational
complications in W
who are nicotine and
alcohol addicts.
not reported
42% of PW reported alcohol consumption during pregnancy: 0.2% - 1% fell
into the category of "heavy drinkers" (abused alcohol during pregnancy).
139 PW (6-40 weeks
gestation). 40 smoke,
but not consuming
alcohol; 32 regularly
use alcohol, but do not
smoke, 35 use neither.
not
reported
Assessment of W's
levels of alcohol
consumption during
pregnancy.
19962003
To compare,
retrospectively, the
prevalence of selected
maternal and lifestyle
factors/reproductive
outcome of working
W in 2 cities and to
assess the quality of
pregnancy-outcome
data.
550 PW: 500 from
maternity welfare
centers, and 50 from a
website for future
mothers.
1,696 W from selected
workplaces.
49.9% of PW consume alcoholic substances, 9.4% of W were heavy drinkers
before pregnancy. Amongst them, 66.7% drank during pregnancy. All of them
were above 31 years of age. 51.1% quit consumption in 1st trimester.
Alcoholics have an increased risk of termination during their pregnancy and
delivery. Combinations of tobacco and alcohol leads to significant increase in
complications during pregnancy and delivery. Tobacco and alcohol use lead to
immune disorders.
171 W (34.2%) reported consumption of alcohol during pregnancy (22 of them
drank once a week, 55 W drank once a month, and 94 W drank less than once a
month). High levels of alcohol consumption were found in 46 W (9.2%). 0 W
questioned by the website drank.
not
reported
To study the health
status of newborns
and the disturbances
of macro- and microelement combinations
in biosubstrates of the
"mother-newborn"
110 mother-newborn
pairs from W's
consultations and
maternal hospitals.
Two groups: 60 PW
who consumed alcohol
before/during their
The W had experienced 7,254 pregnancies in total, an average of 4.3
pregnancies per W. Approximately ½ of the reported pregnancies from each
city were terminated and ¾ had undergone an induced abortion. 86 (3.1%) of
the W from Mončegorsk and 39 (6.5%) from Apatity drank alcohol during
pregnancy.
Alcohol consumption was related to pregnancy and labour complications such
as extragenital pathology (66.6%), complicated obstetric-gynecologic
anamnesis (83.3%), complications during pregnancy (63.3%), premature birth
(16.6%), accelerated labor (23.3%), and pathology of amniotic fluid (11.6%).
Newborns with PAE were observed with retarded intrauteral development
(symmetrical type; 56.6%), abstinence syndrome (70%), early/long-term
jaundice (43.3%), pathological loss in body mass (38.3%), and congenital
2
Reference
Country, City
Year of
study
Purpose of the study
Sample
system when the
mother consumes
alcohol.
pregnancy and 50 W
who did not.
To study reproductive
pathologies in Slavic
W (states of the CIS)
with a focus on
alcohol use/abuse and
to study the health of
newborns of W who
drank alcohol prior to
pregnancy.
To study the state of
the fetoplacental
system for a better
pregnancy outcome
and childbirth of
drug- and alcoholdependent W.
387 W of reproductive
age and 47 W in labour
during the first 3 days
after giving birth from
maternity welfare
centers and maternal
hospitals from three
regions of CIS.
Kalinina et
al., 2012 (in
Russian)
Russia,
Moscow
20062008
Komarova,
2008 (in
Russian)
Russia,
Moscow
not
reported
Ogotoeva
and
Borisova,
2008,
Ogotoeva et
al. 2009a,b
(3
publications;
in Russian)
Orazmurado
v et al., 2007
(in Russian)
Russia,
Yakutsk
not
reported
To study the state of
health, social level,
macro- and microelemental blood
content of PW who
were and were not
consuming alcohol.
20 W with low SES in
their 1st and 3rd
trimesters of
pregnancy.
Russia,
Moscow
not
reported
To study the effects
of alcohol use and
tobacco smoking on
pregnancy and
delivery outcomes.
50 alcohol consuming
and cigarette smoking
W.
Shilko et al.,
Russia,
not
To investigate the
28 PW at the maternity
103 PW from the
pathological
pregnancies unit of the
city's hospital and city's
maternity home.
Findings
developmental abnormalities (16.6%). Alcohol consumption in PW leads to a
decrease of micronutrients (Cu, Zn) in the 1 st and 3rd trimester of pregnancy,
respectively, leading to a decrease of serum Zn in newborns. With alcohol
consumption, there is a decline in the essential minerals in the mother's hair
(Co, I, Mg, P) and an accumulation of toxic substances (Ni, Pb, Sr). In children
with PAE, a deficit of essential minerals (Co, Fe, I, Zn) and an increased levels
of Li and Ni were observed.
Newborns of W who consumed beer and energy drinks before pregnancy had
significantly lower scores on the Apgar scale, were born in earlier stages of
pregnancy, and had lower body mass when born. The level of hemodiastase is
higher in W abusing beer before the pregnancy than in those who abstained
from alcohol or consumed hard liquor in a small dosage before the pregnancy.
The newborns of these mothers have a lower level of blood protein, folic acid,
and a higher level of hemodiastase than in newborns of abstainers or of those W
who consumed only hard liquor before pregnancy.
46.9% of W consumed alcoholic beverages. Of the drinkers, 9.4% were "heavy
drinkers" and 66.7% drank during pregnancy. In the 1st trimester of pregnancy,
53.1% of W stopped drinking. PW consuming alcohol had statistically
significantly more often: threatening miscarriage during pregnancy, hypamnions
(12.5%), placental insufficiency (71.8%), premature rupture of fetal membranes
(28.1%), rapid labor (34.4%), birth traumas (15.6%), and antenatal fetal death
(3.1%). Alcohol consumption led to immune impairments, mostly a hyperactive
state of immune system functioning (59.4%).
The comparative analysis has shown that socially uncomfortable W have more
changed parameters and a tendency for bad habits (smoking, the use of alcohol).
Мacro- and microelemental structure in the blood of PW in the 2nd group has
been subjected to change to a greater degree. Specifically, they were
authentically low in Zn and Cu levels. These changes have been revealed in the
period close to conception and in the first trimester of pregnancy.
Three groups: 1. 11 W (22%) smoke 15-20 cigarettes per day; 2. 20 W (40%)
consume alcohol regularly; 3. 19 W (38%) consume alcohol regularly and
smoke 15-20 cigarettes per day. Among the 3 groups, the most frequent
complication was chronic fetal placental insufficiency (91% in 1, 70% 2, and
89.4% in 3). Fetal hypotrophy was observed equally in 1 and 3 and not seen in
2. In 3, complications of pregnancy were observed 2.2 times more often than in
1 and 7 times more frequently than in 2. Pregnancy complications were seen 1.5
times more often in 1 than in 2.
TGF-β1 levels were 71.7 ng/ml and 6.6 ng/ml in alcohol-misusing W and the
3
Reference
Country, City
2010c,
2011c (2
publications
;in Russian)
Yekaterinburg
Year of
study
reported
Uliyanovskai
a and
Solovev,
2010 (in
Russian)
Russia,
Arkhangelsk
not
reported
PREVALENCE OF FASD (n=17)
Albers et al., USA (Floating 19911997 (in
Hospital for
1995
English)
Children and
the University
of Minnesota
Hospital)
Aronson,
2003 (in
English)
Russia
19941997
Bubnov,
2009, 2010
(2
publications;
in Russian)
Russia,
Yekaterinburg
20052009
Farina et al.,
2004 (in
English)
USA
not
reported
Purpose of the study
Sample
Findings
levels of TGF-β1 in
the blood of pregnant,
alcohol-misusing W
and in a control
group.
welfare centers (8 W
with alcohol
dependence and 20 W
in control group).
To examine the
features of the sociopsychological status
in the mother-fetus
dyad in W consuming
alcohol.
152 non-alcohol
dependent PW from
maternal houses.
To analyze the preadoptive medical
reports of children
adopted from EE and
the FSU and to
compare these with
their evaluations from
the USA.
To determine the
prevalence of FAS
and FAE in children
pending adoption
from Russia.
To observe
morphofunctional
irregularities of the
developmental and
CNS in infants with
PAE and to determine
the prevalence of
FASD among
children from
orphanages/the
general population.
56: 26 men and 30 W
(medical records were
only available for 47
children) from adoption
clinics.
In a comparison of children's pre-adoptive medical reports from EE and the
FSU to reports after their arrival in the USA, it was found that frequent delays
of psychosocial growth occurred in a limited period of time in an institution.
Also, there were some discrepancies between the pre-adoptive evaluations and
the evaluations in the clinics. Maternal alcohol use was cited in 19% of the 302
medical records submitted to the American clinics for pre-adoptive review;
however, only 1 (1.8%) of the 56 children seen in the adoption clinic had FAS.
131 pre-adoption
medical abstracts from
an orphanage.
2 (1.53%) children with FAS; 15 (11%) of children exposed to alcohol are at
risk for FAE. Extrapolating from this number of actually diagnosed FAS cases
would result in an FAS rate of 15/1000 per live births.
813 children in total:
445 children from
orphanages (2 months 4 years),
326 children from preschools (1.5 - 6 years),
and 42 children from
middle school (11
years).
To evaluate the
effects of
institutionalisation
29 adoptive families of
children from Russia
Physical and psychophysical development showed growth impairment/
retardation for children with FAS (100%) and pFAS (100%) during infancy.
The frequency of defects is significantly higher in the FAS group than in the
control group (62.5% vs. 19.6%), mostly CNS defects (43.7% vs. 12.5%). In
FAS-affected children, a there was a high frequency of anatomical changes of
visual organs and significant hearing loss (in 43%). Analysis of motor skills
with the Denver test showed retardation in 81.3% of children from orphanages.
The mean level of TGF-β1 in the blood serum of the FAS group was higher
than in the non-FAS group (71.2 vs. 45.61 ng/ml). 2) According to the
anamnesis data, 41.6% of orphans had intrauterine growth retardation, 15% of
them were diagnosed with FAS and 24.7% with pFAS. 1.8% of the preschool;
children were diagnosed with pFAS and 0 were diagnosed with FAS.
Intrauterine alcohol exposure, affects 39.2% of orphans (400 per 1000).
10 of the 29 children (34%) were diagnosed with ARND.
control group, respectively (collected at 11-14 weeks of pregnancy). The same
results were observed in rats. High concentration of TGF-β1 in blood was
observed in pregnant animals that were given alcohol (189 ng/ml), when
compared to the control group (129.7 ng/ml). A lack of TGF-β1 receptors,
which is related to alcohol-use can explain the fetoplacental insufficiency and
in-utero fetal development delay in FAS.
PW who consume strong alcoholic beverages but do not have a diagnosis of
alcoholism, are more likely to be unmarried and have unplanned pregnancies.
68.5% of these PW have lacked readiness for pregnancy and have been
observed to ignore their pregnancy. It is necessary to provide psychosocial
support for W during pregnancy planning to ensure the best outcome for both
the mother and baby.
4
Reference
Country, City
Year of
study
Grigovich et
al., 2006 (in
Russian)
Russia,
Republic of
Karelia
19982003
Malakhova,
2012 (in
Russian)
Russia,
Yekaterinburg
20052011
Malakhova
et al., 2008
(in Russian)
Russia,
Yekaterinburg
not
reported
Marincheva
et al., 2003;
Konovalova,
et al., 2009
(2
publications;
in Russian)
Russia,
Moscow. USA
New York,
San Diego
not
reported
Purpose of the study
and parenting stress
on the quality of
attachment/behaviour
of Russian children
adopted in the USA.
Prevalence
calculations of FAS
in Russia based on
data from the
Republic of Karelia.
Sample
Findings
1594 newborns from
the premature baby unit
of the children’s
hospital.
FAS was diagnosed in 1.7% of premature babies: 28 children (11 M, 17 W). All
children had CNS damage, and isolated/combined developmental impairments
of other organs and systems. All mothers of FAS children were from "socially
at-risk families", 19 abandoned their children. The authors propose that FAS
should be perceived as a form child abuse and a serious social/medical problem
that has not received sufficient attention from the public health system/state.
Children from boarding school facilities have an FAS prevalence of 139 per
1000 and the prevalence in the general population is 18-19 per 1000 (pre-school
institutions). Retardation of neuropsychological development (social adaptation,
fine motor skills, gross motor skills, speech) was found in 90.5% of FASaffected children. The results were used to develop a model of the pathological
process of FAS - proposed as a number of complex pathogenic elements of
FASD conception (preconception, intrauterine, neonatal, postnatal periods).
To determine the
prevalence of FAS in
boarding schools and
in general population
and to develop a
pathogenic scheme
(conceptual model) of
the functional and
structural changes
that determines the
main clinical
symptoms of the
intrauterine effects of
alcohol on infants.
To assess the
incidence of delayed
manifestations of
FAS/FASD.
1,221 children and
youth
To determine the
incidence of FAS
among children and
adolescents in
boarding schools with
special programs,
orphanages with
regular and special
3,675 children and
adolescents (7 - 21
years) from boarding
schools with special
programs, orphanages
with regular and special
programs, and schools
of the social welfare
121 children from
specialized orphanages
(3 months - 4 years of
age; 50 boys and 71
girls).
Children were divided in 4 groups according to 4-digit diagnostic code for
FASD. 45.5% of children from specialized orphanages are at risk for
developing FASD. 17.4% of these are considered to be high-risk, and 28.1 %
are of average/low risk. The high-risk group was 42.9% boys. The group with
no risk was 61.2% girls. A proportional retardation in weight and height was
demonstrated in children of the high-risk group, but non-proportional
retardation in other cases was frequent. Psychological-pedagogical
characterization showed a relatively steady rate of retardation in sensorimotor
functions, emotional-volitional and communications spheres.
320 cases of FAS (8.71%) were identified in total: 171 (53.44%) M, and 149
(46.56%) W. The incidence of FAS was 12.94% in the boarding-orphanage,
5.82% in boarding schools, 4.9% in the regular orphanages, and 16.4% in the
schools of the social welfare system. It was suggested that children from
orphanages had higher IQs than the children from the boarding schools (mean
IQ 70.6 and 65.5, respectively). The most significant differences were in the
non-verbal traits (72.7 and 80.4, respectively). This may suggest the importance
of social deprivation in the development of mental retardation even in such
5
Reference
Country, City
Year of
study
McGuinness
et al., 2000
(in English)
USA
(recruitment
letters sent via
adoption
agencies in
Penn., Md.,
Calif., and a
state chapter
of the
FRUASG)
1997
Miller et al.,
2007 (in
English)
Russia,
Murmansk
not
reported
Palchik and
Legonkova,
2011;
Legonkova,
2011 (2
publications;
in Russian)
Russia, SPB
2004 2010
Riley et al.,
2003 (focus
on section by
Mattson et
al.: «FAS in
Moscow,
Russia»; in
English)
Russia,
Moscow
Initiated
in 1999
Purpose of the study
Sample
Findings
programs, and
schools of the social
welfare system.
To characterize the
current social,
academic, and
conduct status of 6-9
year-old children
adopted from the FSU
and to evaluate risks
and protective
influences of adoptive
families and their
relationships to
competence.
To survey the health
of young children
residing in Russian
orphanages.
To examine the
prevalence of children
with FAS, as well as
clinical and
neurophysiological
symptoms by age
groups.
system.
specific physical brain disorders like FAS.
101 parents who had
105 children (50 boys;
55 girls) from adoption
agencies.
7 parents reported that their child had FAE. Alcohol abuse by the birth mother
was common (41%).
193: 105 boys and 88
girls from an
orphanage.
FAS prevalence was 10% and mothers of these institutionalized children had
histories that included tobacco use (41%), alcohol use (39%), and illicit drug
use (7%).
111 children with FAS:
62 boys and 49 girls
(34 weeks - 7 years);
and 23 children with
FAS (dynamic clinical
observation)
To find the rates of
FAS among children
in orphanages and
boarding schools and
to determine how
children have FAS
and to compare
children matched for
IQ and living
environment in USA
2352 children from
orphanages and
boarding schools.
The prevalence of FAS in maternity hospitals was 0.79 - 3.62 per 1000 live
births during 2000–2009 (0.3-3.5% in specialized neonatal clinics; 4.6-9.3% in
the psycho-neurological orphanages; 42.7-68.0% in "psycho-correctional"
orphanages; and 46.4-68.0% in orphanages for children with developmental
abnormalities). Facial dysmorphic signs, microcephaly, growth and weight
retardation, microcephaly and neurological deviations with development of
motor, mental and speech delay are typical for children with FAS. EEGs
showed immature, asymmetrical patterns in neonates and focal slow-wave and
paroxysmal activity in babies and children. Alcohol use pattern of PW was
found to correlate with the development of facial dysmorphic features,
intrauterine growth retardation, microcephaly, and EEG patterns.
186 (7.9%) children were diagnosed with FAS by Russian pediatricians.
6
Reference
Country, City
Year of
study
20052006
Robert et al.,
2009 (in
English)
Canada
Stromland et
al., 2005
(focus on
section by
Mattson and
Riley:
«Compariso
n of FASD
in Moscow,
Russia and
San Diego,
California»;
in English)
Sofronova
and Palchik,
2012 (in
English)
Russia,
Moscow
not
reported
Russia,
Yakutia,
Sakha
Republic
not
reported
The St.
PetersburgUSA
Orphanage
Research
Team, 2005
(in English)
Warren et
al., 2001 (in
English)
Russia, SPB
20002002
(baseline)
Russia,
Moscow
not
reported
Purpose of the study
Sample
Findings
To assess physical
and ND status to
identify FASD in
children adopted from
Eastern Europe.
29 children (17 boys
and 12 girls); Children
were from: Russia
(42%), Belarus (35%),
Romania (10%),
Poland (7%), Georgia
(3%), and Yugoslavia
(3%).
not reported.
Five years after adoption, facial evaluation demonstrated moderate FAS features
in 7% (N=2) of children.
Individuals in 13
regions, orphanages,
and the National
Medical Centre (no
sample size is stated)
The prevalence of alcohol consumption ranged from 0.7 to 6.1%. Among those
who were drinkers, between 0.2 to 4.5% drank heavily. The incidence of FAS
varied from 0.06 to 0.9% in different regions. There were no correlation
between the level of maternal alcohol consumption and incidence of FAS (r =
0.559; p = 0.093). The incidence of FAS varied from 0.3% in the National
Medical Center to 11.3–34.0% in the orphanages.
FAS prevalence in children's homes/orphanages was 33%.
To determine the
prevalence of FAS in
orphanages and
boarding schools; to
compare the ND
status of children with
FAS and children
matched for IQ and
living environment;
and to compare ND
status of children with
FAS in Moscow and
San Diego.
To determine the
prevalence and
patterns of alcohol
consumption for PW
and to determine the
incidence of FAS.
To provide baseline
information on
conditions in
orphanages in the
Russian Federation.
To determine
incidence of FAS
within specific
populations in Russia
(2 special schools; an
orphanage; and a
boarding school).
325 children from
orphanages.
184: 123 boys and 61
girls from an orphanage
and a boarding school.
211 (5.5%) children have a confirmed diagnosis of FAS.
FAS was diagnosed in 14.1% of subjects; FAS incidence in the orphanage was
almost 3 times higher than in the boarding school.
7
Reference
Country, City
Year of Purpose of the study
Sample
Findings
study
EFFICACY OF PREVENTIVE MEASURES, METHODS OF DIAGNOSTICS AND INTERVENTIONS OF INDIVIDUALS WITH FASD (n=10)
Prevention (5)
Balachova et Russia, SPB
not
To determine
51 (23 Russian
Data from 7 focus groups showed that only a few people knew the term FAS
al., 2007 (in
reported physicians'
physicians, 23 W, 5
and the majority were not aware of its symptoms/demonstrated misconceptions.
English)
knowledge, attitudes,
male partners); from
The participants had limited knowledge about the effects of alcohol on a fetus
and behaviour related W's clinics, a college
and some participants were uncertain that there might be negative effects.
to drinking during
adult education
pregnancy.
program, a substance
abuse treatment center,
and continuing medical
education programs.
Balachova et Russia, SPB
not
Development of a
648 W of childbearing
FASD is not well recognized by W or specialists such as doctors, psychologists,
al., 2010a,b
reported prevention program
age (301 of them PW)
nurses, and social workers. A 3 hr FASD education module included in
(2
on FASD.
and 203 physicians
continued medical education leads to significant changes in physicians’
publications;
(103 pediatricians and
knowledge, attitudes, abilities to diagnose FASD and conducting brief
in English
100 gynecologists). 700 prevention interventions.
and in
W from W's
Russian)
consultations.
Balachova et Russia, SPB
not
To determine W’s
210 W of reproductive
Different types of informational leaflets with positive, negative and neutral
al., 2012b;
reported preferences for
age from city W’s
information increases the general awareness of W of childbearing age about
Regentova,
“positive” or
clinics.
FAS, stimulates them to change their behavior by abstaining from alcohol in
2012 (2
“negative” education
case of pregnancy, and it decreases the level of alcohol consumption among W
publications;
materials and to
in general.
in Russian)
develop and assess
the efficacy of these
materials for FASD
prevention.
Isurina et al., SPB, Nizhny
not
To retrieve
7focus groups: doctors, 3 types of typical attitudes towards alcohol consumption during pregnancy were
2009 (in
Novgorod,
reported information about the PW, W of childbearing discovered: 1) Loyal attitude – “It is tolerable to consume low doses of alcohol
Russian)
and
attitudes towards
age, W with alcohol
in cases involving a healthy pregnancy”; 2) Complete refusal from alcohol
Oklahoma,
alcohol consumption
dependence problems,
consumption during pregnancy; and 3) Inconsistent attitude – “It is important to
Russia
during pregnancy, the and husbands/partners
convince PW to abstain from alcohol consumption during pregnancy; however,
prevalence of alcohol of PW; 900 W were
good quality alcoholic beverages can be consumed at the late stage of
consumption during
interviewed in total.
pregnancy”. The first type of attitude is typical for obstetrician-gynecologists,
pregnancy, and
the second type for medical doctors specializing in addiction treatment, and the
factors that influence
third type for pediatricians. Doctors do not provide W with adequate
drinking habits of
information about alcohol on the fetus and FASD. Medical doctors (except
PW.
pediatricians) have a poor level of knowledge on FAS/FASD.
Moskalenko, Moscow,
not
To increase
N/A
There are several high risk factors for alcohol consumption during pregnancy:
2002,
Russia
reported knowledge of medical
single status, young age (17-32), unemployment, frequent smoking and
2008a,b (3
professionals on risk
drinking, a history of rape or incest, partners who are suffering from alcoholism,
publications;
factors of alcohol
low educational background, and adolescents (15-19; they are at risk of alcohol
8
Reference
Country, City
Year of
study
in Russian)
Purpose of the study
Sample
exposed pregnancies.
Diagnostic (3)
Jones et al.,
Russia,
2006 (in
Moscow
English)
not
reported
Kuznetsova
et el., 2011
(in Russian)
Russia, Orel
not
reported
Shilko et al.,
2008a,
2009c, 2010
b, 2011a (3
publications;
in Russian)
Treatment (2)
Khasianova,
2010 (in
Russian)
Russia,
Yekaterinburg
not
reported
Russia
Khimki,
Moscow
Region
not
reported
Findings
abuse in an unplanned pregnancy as a psychologically traumatic experience).
Prevention is largely through primary care physicians and positive
reinforcement is recommended.
To examine the
pediatricians’ ability
to accurately diagnose
FAS after a structured
training program.
To determine the
sensitivity and
specificity of the
facial abnormalities
triad in orphans as a
marker for FAS.
To effectively analyze
the CDC diagnostic
system for screening
diagnostic features of
FAS in orphanages.
110 children in
boarding schools and
orphanages.
To study the clinical
peculiarities of FAS
and the usefulness of
including
antihomotoxic
(Traumeel S), and
peptide (NeyFoc)
medicine in therapy.
To analyze
transcranial direct
current stimulation
(tDCS) as a therapy
for children with
FAS.
56 children with FAS
were examined: 35
boys and 21 girls with
an average age of 7
years ± 0.4 months
from the city hospital.
96 medical records of
children from
orphanages.
120 children (3 months
- 4 years) from
specialized orphanages.
79 out of 110 children were identified to have FAS by the pediatricians; in 66
(83.5%) of these children, the diagnosis was confirmed by the
dysmorphologists. Among 31 children who were classified as deferred (possible
FAS) by the pediatricians, 21 (67.7%) were confirmed with either FAS or
deferred by the dysmorphologists.
There were 4 groups identified: 1) 7 children (7.2%) with confirmed maternal
alcoholism that present the triad of FAS facial abnormalities; 2) 19 children
(19.8%) with confirmed maternal alcoholism without FAS facial abnormalities;
3) 6 children (6.3%) with no maternal alcoholism with facial abnormalities; and
4) 71 children (74%) with no maternal alcoholism without facial abnormalities
(control group). The sensitivity of the FAS triad was 27%, specificity was 93%.
3 groups of children were identified: 1) presence of all FAS features (N=32); 2)
pFAS features (N=32); and 3) presence of one FAS feature or their absence.
There was a high frequency of birth defects related to FAS/FASD, mostly
pertaining to the neural system. Psychological/pedagogical judgment revealed a
deficit in the sensorimotor emotional-volitional and communicative sphere.
After conducting peptide-antiminotoxic therapy with FAS patients, the
activation of psycho-motor development starts in 56-77.0% of cases, while the
effect of standard therapy is not higher than 44.8%.
Malakhova
Russia,
not
Children from an
The tDCS method is noninvasive, easily administered, efficient, and has no
et al., 2011;
Yekaterinburg reported
orphanage: 13 with
contraindications. In children with FAS, it has a positive synchronizing effect
Malakhova
FAS that did receive
on the mechanisms of neuroregulation and circadian activity of the brain, as
and Bubnov,
tDCS, 9 with FAS that
well as a normalization of the altered sleep-wake cycle.
2011 (2
did not receive tDCS,
publications;
and 10 without FAS
in Russian)
who received tDCS.
LITERATURE REVIEWS AND EDUCATIONAL MATERIALS FOR HEALTH PROFESSIONALS (n=28)
Akhmadeeva Russia, Ufa
not
To describe the main
N/A
Alcohol consumed during pregnancy has direct and indirect teratogenic and
1997 (in
reported problems caused by
feto-toxic effects on the fetus. Complications include high rates of
Russian)
FAS.
morbidity/mortality in the early stages of development, intrauterine growth
retardation, defects of CNS development, functional/metabolic defects, and
9
Reference
Country, City
Year of
study
Purpose of the study
Sample
Alipov and
Korkhov,
1988 (in
Russian)
USSR,
Leningrad
not
reported
N/A
Anokhina
and
Moskalenko,
1987 (in
Russian)
USSR,
Moscow
not
reported
To provide an
overview for medical
professionals of the
destructive effects of
alcohol on fetuses,
newborns, and
children.
To increase medical
professional’s
knowledge of FAS.
Badalyan,
1986 (in
Russian)
USSR
not
reported
N/A
Bakanov,
1986 (in
Russian)
USSR
not
reported
Bakanov,
1999 (in
Russian)
Russia
not
reported
Balachova et
al., 2012c (in
Russian)
Russia, SPB
20032012
Bisiarina and
Lisitcyna,
1987 (in
Russian)
USSR, Omsk
not
reported
To increase FAS
awareness amongst
neurologists,
psychiatrists, and
other physicians for
prophylaxis.
To increase FAS
awareness for
physicians, obstetricgynecologists, and
different specialty
physicians.
To increase
knowledge of the
effects of PAE on
fetuses/children for
pediatricians.
To increase
awareness of FAS in
physicians and
psychologists.
To increase medical
professional’s ability
to prevent alcohol
consumption by
PW/breastfeeding W.
N/A
N/A
N/A
N/A
N/A
Findings
progressive psychiatric decline.
The severity of the disorder depends on the timing of PAE. The most severe
outcomes occur if alcohol is used throughout the pregnancy. Increases in
quantity of concentration of alcohol increase the negative effects of PAE. The
most seriously affected children are born to 2 alcoholic parents. If M consumed
alcohol on the day of conception, changes are observed in the fetal brain. PAE
leads to spontaneous abortions, toxicities, preterm deliveries/ruptures, poor
uterine contraction strength, maternal trauma, and pathological bleeding.
PAE causes FAS. Children with FAS have low attention spans, high
distractibility, and behavior disorders. According to the literature, prevalence of
FAS is 1-2 per 1000 live births. This number might be much higher because
mild cases are ignored. The amount of damage does not only depend on the
amount of alcohol consumed. The most damaging agent is acetaldehyde – the
most toxic metabolite of ethanol. The combination of metabolic and functional
disturbances in the body of mothers plays an important role in FAS
development (e.g., smoking, food, and drug intake).
FAS manifestation increases in severity with: hyperemesis gravidarum, risk of
abortion in first trimester, maternal chronic and infectious disease, and a
combination of alcohol and nicotine. Differential diagnosis has to be made in
the first few months of life regarding non-specific perinatal hypoxic
encephalopathies in severe FAS, regarding chromosomal abnormalities
(Edward’s Syndrome) and chromosomal unsteadiness (DeLange Syndrome).
20-50% of alcohol-consuming parents have a child with FAS. Alcoholic
embryopathy develops from the direct effect of alcohol/acetaldehyde on the
fetal tissue. The leading factor in FAS development is the insufficient alcohol
dehydrogenase activity leading to an increase in acetaldehyde in the blood.
Organ and tissue damage is related to hypoglycemia. Some of the symptoms in
FAS may be attributed to the suppression of DNA, RNA, and protein synthesis.
Consequences of alcohol consumption during pregnancy on the embryo and
fetus are observed, one of which was the development of FAS.
A definition for FAS is given with descriptions of special characteristics,
diagnostics, epidemiology, mechanisms, and FAS risk factors are also provided.
Prevention of FASD, and a description of brief interventions aimed at
preventing FAS/FASD are discussed.
It is absolutely contraindicated to consume alcohol during pregnancy. In
addition to FAS, there are also other known harmful effects of PAE, which can
stem from alcohol consuming W breastfeeding their newborn. Other
consequences to PW drinking alcohol include alcohol poisoning, chronic
childhood alcoholism, and early dependence to alcohol in children and
10
Reference
Country, City
Year of
study
Purpose of the study
Sample
Frolova and
Nikolaeva,
1987 (in
Russian)
.asheva and
Konstantino
va, 1988 (in
Russian)
Kiriushchen
kov, 1986 (in
Russian)
USSR
not
reported
N/A
USSR,
Leningrad
not
reported
USSR,
Moscow
not
reported
Koshkina et
al., 1998 (in
Russian)
Russia,
Moscow
1998
To increase the level
of knowledge of
FASD in Ob/Gyn and
other specialists.
Increase the
knowledge of
FAS/FASD for
medical professionals.
To describe the effect
of alcohol on
embryonic and fetal
development.
Summary of studies
on consequences of
alcohol use among W,
adolescents, children
and families.
Lebedev,
1974 (in
Russian)
USSR
not
reported
N/A
Lezhepekova
, 1981(in
Russian)
USSR
not
reported
Lisitcyn and
Sidorov,
1990 (in
Russian)
Mastiukova,
1986 (in
Russian)
USSR,
Moscow
1990
USSR
not
reported
Mastiukova,
1989 (in
USSR
not
reported
To increase level of
knowledge in medical
professionals on
FAS/FASD.
To increase the level
of knowledge of
medical specialists on
alcohol-related issues.
To increase
physicians' awareness
of FAS and problems
associated with PAE.
To enhance
knowledge amongst
specialty physicians
of the problems of
alcohol, pregnancy,
and FASD.
To describe the data
on alcohol’s
N/A
N/A
N/A
N/A
N/A
Findings
adolescents.
Using alcohol once during pregnancy can lead to the development of birth
defects (difficult to diagnose in the early years of a child’s life). The influence is
variable throughout pregnancy, with the highest risk in the 1 st trimester. The
teratogenic dose of alcohol is 60-80g/day of pure alcohol.
A description of FAS and the influence of alcohol on the developing brain are
provided. There is a discussion of acetaldehyde’s role in fetal CNS damage in
alcoholic W. Other reasons for the negative effects of alcohol on the fetal brain
such as caloric/qualitative starvation, and vitamin deficiency are described.
Clinical data analysis and experimental animal results indicate that PAE is
dangerous to the mother and fetus. The best prophylaxis is complete abstinence
from alcohol during pregnancy. It is imperative to discuss the choice of ending
the pregnancy in chronically alcoholic W in the early stages of pregnancy.
Alcohol influences the offspring in three main ways: direct influence on
gametal cells (drunk conception); damage to the reproductive organs
(testes/ovaries) from chronic alcohol use; and direct influence on the developing
organism during pregnancy. Alcohol consumption during breast-feeding also
has negative effects. A dependency of fetal development on alcohol dosage was
observed: daily consumption of 150g of alcohol increased the risk of fetal
damage by 50%. 1/3 of children born to alcoholic mothers were diagnosed with
mental retardation. A significant number of children died in the first 2 years,
thereby the relative number of mentally retarded children increased to 54.1%.
Maternal alcohol consumption during pregnancy damages the fetus by affecting
maternal-fetal circulation with alcohol’s breakdown products disorganizing the
metabolism as a whole. It also increases the damaging effects of other
substances and predisposes the fetus to inherited diseases.
Alcohol consumption during pregnancy has toxic effects on the fetus. It can
cause a variety of birth defects, mental health and neurological issues. Alcohol
exposed children are capricious, moody, unstable, inattentive, restless,
hyperactive, struggle in school, and experience developmental retardation.
Data are presented on prevalence and clinical implications of FAS, pathogenesis
of toxic influences of alcohol on the fetus and methods of prevention of FAS.
N/A
Maternal and paternal alcoholism negatively affects neuropsychiatric
development of the child.
N/A
There were a high frequency of vision disturbance in FAS, 1 was a defect in the
oculo-neurologic apparatus (anomalies of ocular nerve and retinopathies). The
11
Reference
Country, City
Year of
study
Russian)
Purpose of the study
Sample
teratogenic effect on
the fetus, its vision,
and intellect.
Palchik et
al., 2006 (in
Russian)
Russia, SPB
2006
To present
FAS/FASD
prevalence and to
increase physician’s
awareness of FAS
and problems
associated with PAE.
N/A
Palchik and
Shabalov,
2009 (in
Russian)
Russia, SPB.
not
reported
N/A
PetrovMaslakov,
1961 (in
Russian)
USSR,
Moscow
not
reported
To increase the level
of awareness of
doctors and medical
school students about
neonatal toxic
encephalopathy of
different etiology,
including
FAS/FASD.
To educate Ob/Gyns.
Popova,
2010 (in
Russian)
Russia
not
reported
To describe
disturbances in brain
ultrastructures among
offspring of rats who
had PAE.
N/A
Radzinsky
and Kostin,
2009 (in
Russian)
Russia,
Moscow
2009
N/A
Ramazanova
and
Semiatov,
2002 (in
Russian)
Russia,
Moscow
not
reported
To provide a
guideline to Ob/Gyns
on the perinatal risk
factors of maternal
alcohol consumption.
To educate medical
professionals on
FAS/FASD.
N/A
N/A
Findings
teratogenic effects of ethanol in early embryogenesis can explain the changes.
For children who had PAE, speaking and hearing deficits, low level of logical
thinking, attention and memory deficits, and emotional-behavioral defects were
observed. In children with FAS, these impair their education and upbringing.
In observational maternal hospitals, the incidence of FAS during the years of
2003, 2004, and 2005 was 2.7, 1.17, and 3.62 per 1,000, respectively. FAS
morbidity in orphanages in SPB during 2000, 2001, 2002, 2003 and 2004 was
9.3, 8.7, 9.0, 7.0 and 7.3%, respectively. When all 2,352 children (83% of the
sample) from specialized orphanages and elementary schools in Moscow were
examined by pediatricians and qualified by specialists from the USA, 186 cases
of FAS were detected (7.9%). In the specialized neonatal hospital in 2005, 3.5%
of babies had FAS.
Similar developmental patterns of toxic CNS damage in the different stages of
ontogenesis are observed. Also, specific effects on the fetal and neonatal brain
are observed, depending on the nature of the toxic substance (including
alcohol).
Abstinence from alcohol during pregnancy is strongly recommended.
Consuming alcohol during pregnancy affects the development of organs (brain,
heart, liver and others). Children born to mothers who consumed alcohol during
pregnancy have a range of neurological/mental health problems. Children have
developmental retardation and become ill more than children without PAE.
Ultrasound disorganization of sensory and motor cortex of alcoholized rats’
offspring depends on the alcohol intoxication of W before and during
pregnancy. Disorders of brain vascularization and hypoxia-ischemia play an
important role in developing alcoholic brain disorders. Research into primary
vessel and brain vascularization disorder in alcoholic brain damage in offspring
is needed.
The negative impacts of alcohol abuse on the reproductive health of and
polysystemic intrauteral effects of alcohol are described.
Data from literature indicates negative effects of alcohol on the fetus and the
need to develop complex medical strategies to effectively diagnose and correct
disorders. In the review, there are aboriginal (11) and foreign (37) articles.
12
Reference
Country, City
Year of
study
2008
Shilko et al.,
2008b (in
Russian)
Russia,
Yekaterinburg
Shilko et al.,
2011a (in
Russian)
Russia,
Yekaterinburg
2011
Skalny and
Skosyreva,
1987 (in
Russian)
USSR,
Moscow
Skosyreva,
1980 (in
Russian)
Tabolin and
Uryvchikov ,
1986 (in
Russian)
Donetc,
1992 (in
Russian)
Purpose of the study
Sample
To increase the level
of knowledge of
FASD of
pediatricians,
Ob/Gyns and other
specialists.
To increase the level
of knowledge of
FASD of doctors.
N/A
not
reported
To educate Ob/Gyns.
N/A
USSR,
Moscow
not
reported
To educate Ob/Gyns.
N/A
USSR
not
reported
Russia, Tomsk
not
reported
N/A
Findings
There is a problem of alcohol consumption in Russia in regards to PW and W of
childbearing age. Influences of the different types of alcohol dehydrogenases on
alcohol metabolism and the influences on the fetus are described including the
teratogenic influence, and the autoimmune component in the development of
alcoholic embryopathy. The pathology of the placenta with PAE is also
described, as well as clinical manifestations of FAS.
The following topics came under scrutiny: development of the views of the FAS
problem, definition of FAS, biochemical aspects of ethanol influence on the
human organism, clinical epigenetics of alcohol and FAS, alcohol and
pregnancy, clinical features and diagnostic criteria of FAS in infants, and
therapeutic-preventive aspects of FAS.
There is a connection in disturbance of Zn metabolism in the body of W who
were consuming alcohol during their pregnancy and the severity of FASD/FAS
development. The teratogenic effect of alcohol and acetic aldehyde can increase
in the state of Zn deficiency. Food supplements with Zn can be recommended to
W with an alcohol abuse history and their babies.
Regular and periodic alcohol use during pregnancy is dangerous not only for the
mother, but also for the fetus. Pregnancy in alcoholic W is an indicator that the
pregnancy is at risk for termination.
FAS has polymorphic symptoms and a bad somatic, psychiatric, and social
prognosis. This data indicates that there is a need to develop new ways to
decrease alcohol abuse.
To describe the
N/A
available data on the
teratogenic effects of
alcohol on fetus and
development of FAS.
CLINICAL STUDIES, DEMONSTRATING THE LIFE-LONG POLYSYSTEMIC TERATOGENIC EFFECTS OF ALCOHOL ON THE FETUS (n = 22)
To study the
particularities of
psychiatric disorders,
level of severity and
immunologic status
between generations,
whose mothers
suffered from
alcoholism, in order
to increase the
accuracy of FASD
diagnosis and find
treatment by using an
immunomodulator.
155 children (6-16)
from orphanages with
severe mental
retardations, and 25
healthy controls)
Non-psychotic psychiatric disorders amongst children from alcoholic mothers
differs with high frequency residual- organic disorders and mixed pathogenesis
of psychiatric disorders, rather than encephalic. Psychiatric underdevelopment
induced by alcohol is clinically different from oligophrenia with non-alcoholic
etiology: attention disorders, tendency to prevail practical knowledge adaption,
rather than theoretical school material. Oligophrenia in children with alcoholic
mothers, in most of the cases, have somatic manifestation with typical
craniofacial abnormalities. In children from alcoholic mothers, there is
correlation between psycho-neurological somatic disorders. Knowing special
clinical manifestation of oligophrenia and non-psychotic psychiatric disorders
could be used to enhance diagnostic accuracy of FASD.
13
Reference
Country, City
Year of
study
not
reported
Purpose of the study
Sample
Findings
To research the
clinical- biological
indicators in early
childhood amongst
children with
intrauterine
subclinical alcohol
intoxication.
To study indicators of
the mental
development of
children, born to drug
and alcoholdependent W.
To examine the
relation between poor
infant outcomes and
sociodemographic
factors, smoking, and
alcohol consumption.
To estimate the
influence of living
conditions, smoking,
alcohol, and maternal
stress on fetal growth
indices.
109 children with
intrauterine subclinical
alcohol intoxication
and 60 mothers.
Control group: 30
children whose mothers
denied alcohol usage
during pregnancy.
25 children (13 boys,
12 girls) with prenatal
heroin exposure.
25 children (12 boys,
13 girls), PAE. All
from orphanages.
1,404 PW who
attended antenatal care
clinics and their
infants.
Usage of absolute alcohol of 30-60 g/day during pregnancy leads to
carbohydrate metabolism changes in mothers of children. Those changes have
teratogenic effects (unfavorable antenatal and intranatal periods, perinatal CND
damage, and secondary immunodeficiency). Intrauterine-formed homeostasis
keeps its function even after delivery, when there is no alcohol influence. The
homeostasis is what determines the organism's reaction to different factors. This
is a clinical picture of the disease.
1,399 PW and their
infants registered at
antenatal care centers.
100 children (10-16)
50 with a verified
diagnosis of FAS and
50 healthy children
from orphanages.
1,547 individuals
children (different
social statuses, using
psychoactive
substances, using
during pregnancy),
newborns/infants from
psychoactive abusing
mothers, healthy
newborns; infants who
Alcohol consumption was reported by 26% of the responders and ranged from
1.4 to 180.0 ml of abs alcohol per week. Living with parents and occasional
alcohol consumption were associated positively with birth weight. Infants
whose fathers consumed more than 100 ml of abs alcohol per week were thinner
at birth compared with those of non-drinking and moderate drinking fathers.
Poor housing conditions, maternal stress, smoking, and alcohol consumption are
independent determinants of fetal growth in Northwest Russia.
In children with FAS, eye pathology was revealed in 30 children (60%): myopia
(8 children), spasm of accommodation (7), astigmatism (10), hyperopia (5),
strabismus (8), and amblyopia (3). In the control group, eye pathologies were
found in 10 children (21.9 %): myopia (4), spasm of accommodation (3),
hyperopia (1), astigmatism (1) and a dystrophy of retina (1).
Characteristic for children, whose mothers were consuming alcohol during
pregnancy, was growth retardation from first year of life by 3.2%. By 2 years of
age, growth retardation was 27.3%, and by age 4, it was 50%. The special
characteristic of children, who were born from alcoholic mothers, was a slow
(85.7%) and imbalanced physical development (45.5%) in early childhood.
Children born to alcoholized mothers also manifested hormonal imbalances,
especially liver hormones.
Erokhova
and
Bozhenov,
1997 (in
Russian)
Russia
Grechany,
2002 (in
Russian)
Russia, SPB
not
reported
Grjibovski et
al., 2002 (in
English)
Russia,
Severodvinsk
1999
Grjibovski et
al., 2004 (in
English)
Russia,
Severodvinsk
1999
Gummel et
al., 2007a,b
(2
publications;
in Russian)
Kashirskaya,
2010 (in
Russian)
Russia, SPB;
Sweden
not
reported
To study the
functional condition
of the visual analyzer
in children with FAS.
Russia,
Astrakhan
19952008
To optimize the
diagnosis and
prognosis of the
consequences of
psychoactive
substance use on
children's health on
the basis of a complex
biochemical analysis.
Very low indicator levels of mental development in both groups were identified.
Data on the screening methodology revealed better developmental results of the
first group (children of drug-addicted mothers) in fine motor skills, speech, and
social adaptation.
25.5% of W reported occasional alcohol consumption. Education was found to
be the most significant factor associated with poor infant outcome. Increased
maternal age (30+) and being single was also related to increased risk for poor
infant outcome. Smoking, alcohol use, stress, maternal occupation, housing and
young age of the mother were not found to influence poor infant outcome.
14
Reference
Country, City
Year of
study
Purpose of the study
Sample
live in foster homes,
preschool and school
age children who were
born from psychoactive
substance-abusing
mothers,
preschool/school age
children.
575 infants from
psycho-neurological
orphanages in SPB:
228 children, whose
mothers abused
alcohol. 347 children
with perinatal ischemic
encephalopathies.
Khatckel and
Popov, 2005,
2009a,b (3
publications;
in Russian)
Russia, SPB
not
reported
To compare
phenotypic traits and
minor developmental
abnormalities in
orphans with toxicmetabolic and
hypoxic damage to
the nervous system.
Khatckel and
Popov, 2011
(in Russian)
Russia, SPB
not
reported
To study phenotypes
of children from
orphanages in SPB.
882 children from
specialized orphanages.
Khoroshkina
and
Krivtcova,
2010 (in
Russian)
Russia, Omsk
not
reported
To investigate
nicotine and alcohol
effects on the health
status of newborns.
Kornilov et
al., 2005 (in
Russian)
Russia,
Kemerovo
2003
To investigate the
teratogenic influence
of parental alcoholism
on the cognitive and
intellectual
development of their
160 babies (up to 1
month) from a pediatric
hospital of the clinical
maternal home.1: 107
mothers smoked during
pregnancy; 2: mothers
smoked and consumed
alcohol during
pregnancy; and 3: 100
healthy mothers.
72 children (6-14) in
the pediatric
department of Clinical
Psychiatric Hospital.
Parents who are
suffering from
Findings
Regardless of the etiology of nervous system impairment, the total number of
children from orphanages with minor developmental abnormalities
(stigmatization) is higher than in healthy children in the general population.
Moreover, stigmatization of children with nervous system alcohol-related
impairment was higher than in children with hypoxic impairment (12.2±0.6 vs.
7.3±0.8, р<0.001). Children with PAE had significantly more congenital
developmental abnormalities in sight, the respiratory system and an increased
frequency of impairments of the kidneys, cardiovascular and the skeletal
system.
78.2% had a number of minor developmental abnormalities above the critical
level (4X more often than in the general population). All orphans had perinatal
brain damage. Impairment of the central neural system (CNS) due to PAE was
detected in 5% of cases with a low level of stigmatization, in 11% of cases with
an average level of stigmatization, and in 54% of cases with a high level of
stigmatization. Minor development abnormalities due to PAE exposure were
detected in 256 orphans. Dysplasia of connective tissue was detected in children
with PAE and 97% had maximum levels of stigmatization and a maximum
variety of phenotypes (significantly more than other etiologies of CNS damage).
Infants with intrauterine growth retardation were born more often in 1 and 2
(44.3 % and 58.5%, respectively,) compared to 3 (5%). Infants who were
prenatally exposed to nicotine and alcohol were found to suffer prolonged
jaundice and hypotrophy 2X as often as infants who were not prenatally
exposed to nicotine and alcohol. Respiratory infections and inflammations of
skin and mucous membranes were more frequently observed in infants born of
W with tobacco addiction (40.6%, 24.5%, and 15%, respectively).
Disembriogenetic stigmas were found six times more often in infants born to
with tobacco and alcohol addiction, and three times as much on their face and
head.
The results have shown that parents’ alcoholism has serious effects on their
children’s neurodevelopment and is one of the reasons for formations of
undifferentiated mental deficiency.
15
Reference
Country, City
Year of
study
Purpose of the study
offspring.
Kunikovskai
a, 1980 (in
Russian)
USSR
19711975
Legonkova,
2011;
Legonkova
and Palchik,
2009 (2
publications;
in Russian)
Russia, SPB
not
reported
Miller et al.,
2006 (in
English)
Russia,
Murmansk
not
reported
Palchik et
al., 2011 (in
Russian)
Russia, Sakha
Republic
(Yakutia) and
SPB
not
reported
To examine special
characteristics and the
clinical picture of
oligophrenia in
children, depending
on the stage of
maternal alcoholism
during pregnancy.
To study FAS
symptoms by age
groups.
To perform a
systematic survey of
phenotypic features
associated with PAE
among children in
baby homes and to
relate these findings
to the children's
growth, development,
medical, and social
histories.
To determine ethnic
and regional-specific
characteristics of FAS
in Republic of Sakha
and SPB.
Sample
alcoholism: 43 mother
and father, 15 mother;
and 14 father.
613 alcoholic W, 426
of which had children.
197 abused alcohol (all
other diseases were
excluded) 45 had 97
children with
oligophrenia: 42 boys
and 22 girls (7- 15).
46 children with FAS:
16 newborns (30-40
weeks of gestation), 30
children (1 month - 5
years) from an
observational maternity
hospital, specialized
neonatal hospital and
specialized orphanages.
234 children: 121 boys;
101 girls; gender not
recorded for 12
children. All children
were from baby homes.
39 children with FAS
(18 children of
aboriginal race, and 21
European children)
from the maternity
home, specialized
neonatal stationary,
children’s
psychoneurological
home, and corrective
Findings
FAS is in direct correlation with heavy maternal alcoholism. With increased
maternal alcoholism, there is more severe level of mental retardation in
children, more behavioral pathology, and a clearer picture of disembriogenetic
syndrome is seen.
For newborns, there is a characteristic lack of relation between the volume and
pattern of maternal alcohol consumption and EEG indices, morphological, and
neurological symptoms of FAS. In children who are 1 month to 7 years, there is
a relationship between facial dysmorphia with suprasonic characteristics of
brain damage, formation of mental retardation and interhemisphere asymmetry
on EEG (r = 0.429-0.731; p<0.05-0.01). The severity of neural system damage
was associated with the quantity of alcohol consumed by the mother during
pregnancy (r = 0.712-0.896; p<0.05-0.01). Volume and pattern of alcohol
consumption was correlated with defects of inner organs and the formation of
strabismus (r = 0.389-0.404; p<0.05).
13% had facial phenotype scores highly compatible with prenatal alcohol
exposure and 45% had intermediate facial phenotype scores.
Manifestation of FAS varies in different medical institutions in the range of
0.79 to 3.6% in maternity homes, and hits 46.4% in specialized institutions.
Comparison of clinical manifestation of FAS in children from SPB and Sakha
Republic has shown that children less than 3 years of age have small eye
openings, in comparison to Europeans. There is no significant neurologic and
psychomotor disease difference amongst these groups.
16
Reference
Country, City
Year of
study
Purpose of the study
Palchik et
al., 2009 (in
Russian)
Russia, SPB
not
reported
To detect
abnormalities in the
bioelectrical brain
activity of infants
with antenatal
exposure to opioids
and alcohol.
Ruchkin et
al., 2008 (in
English)
Russia,
Arkhangelsk
19992000
Semenov et
al., 1987 (in
Russian)
USSR,
Leningrad
not
reported
To compare 2 models
for the development
of internalizing and
externalizing
behavior problems in
children and early
risk factors using
structural equation
modeling.
To test the hypothesis
that the most
unfavorable factor for
fetal development is
parental alcohol
consumption during
puberty.
Sheffer,
2012 (in
Russian)
Russia, SPB
not
reported
To provide a complex
appraisal of the
anatomic and
functional changes of
sight organs in
children with FAS.
Sample
children’s home.
138 newborns with
opioid abstinence
(withdrawal) syndrome
(OAS), 46 children
with FAS - 16
newborns (up to 40
weeks of age) and 30
children (1 month - 5
years) from an
observational maternity
home, specialized
neonatal hospital and
specialized orphanages.
692 children (ages 1.53.5) and their mothers.
2 groups of children: 1)
120 children born from
fathers who started
alcohol consumption
after child conception
(19-25+); 2) 103
children born from
fathers who started
alcohol consumption
before conception (1418).
150 children (94 boys,
56 girls; 10-16) from
orphanages.
Findings
Differences in EEG indices between FAS and OAS children were observed. In
the FAS children, the main electrographic pattern was the slowing of
bioelectrecal activity in frontal regions х2 = 10.42 (p = 0.0013).
The development of behavioural problems of children is related to maternal
psychological problems and alcohol use during pregnancy and mediated by the
continuing maternal and family dysfunction and compromised postnatal
condition of the child.
There were no symptoms of FAS amongst children of both groups. In group 2,
infectious and chronic diseases were seen more frequently compared to the
other group. They also had more severe neurological decline
(seizure/hypertension); however, the severity of pregnancy and delivery
complications in group 1 was not different from group 2. Thus, the highest risk
of having a child with physical and neuropsychiatric disorders exists in cases of
pubertal parental alcohol consumption. One of the mechanisms of alcohol’s
negative effects on fetuses is a steady metabolism disorder of zinc and copper.
In comparison with healthy children, FAS children 1) had more
blepharophimosis, epicanthus, telecanthus, microphthalmos, ptosis and
strabismus; 2) had a significant decrease of vision, both without optical
correction and with maximum correction; 3) had more abnormalities in
refraction, and hypermetropia was detected twice as often than in controls; 4)
had more abnormalities in smooth pursuit and saccadic eye movements, and had
more abnormalities in motion perception according to the results of the "Motion
perception program"; and 5) had a decreased electrogenesis of outer and inner
17
Reference
Country, City
Year of
study
Purpose of the study
Sample
Shurygin,
1974 (in
Russian)
USSR,
OrekhovoZuevo
not
reported
To compare clinical
manifestations of
alcohol’s teratogenic
effect on children,
who were born to
mothers with and
without signs of
alcoholism.
Sokolovskay
a et al., 2009
(in Russian)
Russia,
Moscow
not
reported
To detect the
influence of parental
alcoholism on the
formation of
disabilities in
children.
42 children (9 months
to 32 years) whose
mothers are suffering
from alcoholism. 1) 19
children born before
their mother developed
chronic alcoholism 2)
children born after
well-developed chronic
alcoholism in mothers.
198 families with
disabled children:
61 families with regular
alcohol consumption
and 137 families who
did not show regular
alcohol
consumption/suffer
from alcoholism.
Usova et al.,
1981 (in
Russian)
USSR
not
reported
Findings
layers of retina and the macular zone.
In 1, most of the children with absent or poorly pronounced cerebral functions
were showing emotional, vegetative, and behavioral disorders. In 2, CNS
disorders were more severe and manifested in the early childhood as different
degrees of mental retardation.
In families with parents who consumed alcohol, low birth-weight children
appeared 2.2X more often. Prolonged features of hypoxia in newborns
(sustained low Apgar Score after 5th minute of birth) in light state of hypoxia
was 1.2X longer, and on average, asphyxia was 1.5X longer. Paternal
alcoholism was associated with the worst developmental parameters in early
childhood (9X more often children had impaired physical development, 2X
more often hydrocephaly, encephalopathy, and rickets were detected.). For
children whose parents abused alcohol, 68.8% of diseases that led to disability
were neuropsychiatric diseases and congenital developmental abnormalities (42
cases). Mental disorders in the main group occurred 1.7X more often. The
overwhelming majority of all mental disorders was mental retardation (77.8%).
The children had characteristic craniofacial abnormalities and developmental
anomalies (heart defect, cleft palate). All children had mental retardation;
however, not all children from alcoholic mothers had these abnormalities (050% risk of development) This may explain that, for developing FAS, several
factors are needed: amount of consumed alcohol, the stage of pregnancy, fetal
nutritional deficits, and genetically determined metabolism characteristics.
To describe the
8 children (5 boys, 3
clinical picture of
girls; 8- 14) with
alcoholic
alcoholic
embryopathy, and the embryopathies.
manifestations of the
teratogenic effects of
alcohol.
EXPERIMENTAL STUDIES ON TERATOGENIC EFFECTS OF ALCOHOL ON LABORATORY ANIMALS OR HUMAN BIOLOGICAL MATERIALS (n=31)
Studies on Laboratory Animals (25)
Anokhina et
USSR,
not
To study the parental
7 week rats, whose
Prolonged usage of ethanol by M before conception leads to a significant
al., 1989 (in
Moscow
reported alcoholization on
parents were influenced disturbance of key points in generation’s catecholamine neuromediation,
Russian)
neurochemical
by alcohol for 4
Alcoholization of W 4 months before conception leads to decreased ethanol
parameters of
months; 37-day rats.
tolerance in their generation, decreased catecholamine synthesis and release
generation.
from presynaptic membrane, ethanol consumption during pregnancy and
lactation leads to disorders of catecholamine neuromediation.
Artiukhina et USSR
not
To compare structural 18 breeds of 3 age
If defect of cortical formation is seen in newborn rats, the weakness in cortical
al., 1989 (in
reported and metabolic rats’
groups of rats: 14-15
development in antenatal alcoholized rats morphologically will be more
Russian)
brain development in
days, 60 days, and 180
pronounced in early postnatal and pubertal periods. In adult experimental rats,
normal and after
days. Structure and
morphological changes of cortex are hidden by compensatory mechanisms,
antenatal
ultrastructure of
which improve brain metabolism of antenatal alcoholized rats.
18
Reference
Country, City
Year of
study
Purpose of the study
alcoholization in
different stages.
Sample
sensorimotor cortex
was studied on 50 rats,
experimental rats had
PAE (15% ethanol).
Mature F rats in a dose
given 4 g/kg ethanol
via gastric injection,
rats with equal amounts
of physiologic solution.
Some F, additionally to
ethanol, received
complex vitamins – α –
tocopherol in a dose of
80 mg/kg, retinol- 1
mg/kg, ascorbic acid –
200 mg/kg.
102 white outbreed rats
(35 M and 67 F).
Arzamasova,
2011 (in
Russian)
Russia, Omsk
not
reported
To identify
characteristics of
pathochemical
exchanges of
carbohydrate-protein
complexes in the liver
in PAE animals and
identify the efficacy
of metabolic
correction in given
conditions.
Babenko and
Skalny,,
1986 (in
Russian)
USSR,
Moscow;
Ukraine,
IvanovoFrankovsk
Russia, SPB
not
reported
To study zinc
metabolism in rats
with chronic alcohol
injection.
not
reported
Study of direct and
indirect ethanol effect
and mother's role in
development of
alcohol-induced
anomalies.
White rats of unknown
quantity. Injected with
Ethanol, Teturam,
Colchicines, or NH4Cl.
Kataeva et
al., 2004 (in
Russian)
Russia,
Ivanovo
not
reported
48 baby rats (5-40 days
old), born to rats that
received alcohol or rats
that did not receive
alcohol.
Kolomeitcev
a and
Levina, 1989
(in Russian)
USSR
not
reported
To study the effects
of chronic alcohol
intoxication of adult
white rats on the
erythropoeisis
performance during
early stages of
postnatal ontogenesis.
To study FAS as a
biological model and
its correction with
injection of SP I-II in
the third trimester of
Chebotar and
Konopistcev
a, 1993 (in
Russian)
F consumed 15%
ethanol solution instead
of water. Control group
was drinking water.
Findings
Prenatal alcohol intoxication is characterized by a significant imbalance of
carbohydrate-protein complexes. Some will remain for a long duration, until the
animals will reach their reproductive age. The protective effect of vitamin
complexes A, E, and C is characterized by a normalizing level of proteoglycans
and collagen in the animals that underwent prenatal alcohol intoxication in
combination with vitamins, in comparison to control animals.
When a chronic 2g/kg alcohol injection into the body of rats is given, Zn
redistribution in tissue is observed. There is also an increased level of
acetaldehyde activity in the plasma and a decrease of K in plasma. The level of
decrease in zinc concentration in neonatal tissue is directly correlated with the
duration of parental alcohol intoxication.
Intrauterine injection of ethanol into the pregnant F (4.8- 7.2g/kg) in every stage
of development leads to development of different anomalies only on day 8 of
the pregnancy in a few fetuses. Medication-induced maternal blood acidosis
could play a significant role in the development of FAS. Possible oocyte
sensitivity to ethanol is determined by its structure, which is different from
mitotic oocytes of somatic cells. Teturam decreases embryotoxic effect of
ethanol. Homeostatic change of maternal organism towards Fe deficiency is a
risk factor, which is a predisposition to embryotoxic effects of ethanol.
Alcohol intoxication of parental animals causes a slowdown of erythropoeisis in
the bone marrow of their breed by 5-20 days; however, these changes are
reversible and during the switch to self-feeding (and therefore the stop of
alcohol intake from maternal milk), the functions of the red marrow regenerate
steadily.
Fetal hypoxia in antenatal alcoholic intoxication is one of the main processes
that lead to FAS.
19
Reference
Country, City
Year of
study
Kolomeitcev
a et al., 1989
(in Russian)
USSR,
Moscow
not
reported
Kurch, 2004
(in Russian)
Russia, Tomsk
20012003
Kurch, 2011
(in Russian)
Russia, Omsk
not
reported
Maizelis et
al.,
1989 (in
Russian)
USSR
not
reported
Purpose of the study
pregnancy.
To explain the
pathogenic
mechanisms of FAS
development.
To detect
morphofunctional
changes in parameters
of the development of
the pancreas with
PAE and to define the
effectiveness of
antioxidants under
these conditions.
To study the
possibility of
correcting the
metabolism disorder
of carbohydrateprotein complexes in
the pancreatic
connective tissue in
prenatally alcoholized
offspring with αlipoic acid.
To study the
effectiveness of
Dalargin use for
correction of
organism functions,
damaged during
antenatal alcoholic
Sample
Findings
43 white male rats.
Offspring of F white
rats consuming 20%
ethyl alcohol during
pregnancy (only source
of fluid), Offspring of F
white rats consuming
water during the
pregnancy.
304 sexually immature
offspring of white
random bred rats
during different stages
of neonatal
ontogenesis.
As an effect of alcohol consumption during pregnancy, the generation born was
found to have changes in behavior, passive-defensive reactions, having a high
possibility of developing depression-like symptoms, long- and short-term
memory disorders, vegetative function regulation disorders, and difficulties with
adapting to surroundings. Also, changes in sleep structure and a decrease in
sleep quality were observed.
270 offspring of white
rats in different stages
of postnatal
ontogenesis. Mature
adult F rats in the
reproductive period
received intragastric
4g/kg ethanol
throughout pregnancy.
F from the other group
received ethanol with
75mg/kg α-lipoic acid.
Control animals: equal
amount of
physiological salt
solution.
F from 5- 20 days
consumed ethanol 6-8
g/kg, control group:
dextrose solution. Into
2 groups: 1) injected
20% solution of
Piracetam and
Usage of α-lipoic acid leads to a decreased toxic alcohol effect on developing
connective tissue component of the pancreas. The protective effect of α-lipoic
acid is a normalization of metabolism processes of carbohydrate containing
pancreatic polymers.
Prenatal alcohol intoxication causes complex changes in structural,
morphometrical and functional parameters of pancreas development in the
postnatal period of ontogenesis with a disturbance of their correlation character.
Alcohol intoxication in the prenatal period causes retardation in pancreas mass
growth during the postnatal period.
Early postnatal Dalargin injection to experimental and control rats led to
significant activation of synthesis of non-water soluble brain protein.
20
Reference
Country, City
Year of
study
Purpose of the study
intoxication.
Morozova
and Popova,
2010 (in
Russian)
Russia,
Moscow
not
reported
Nozdracheva
et al.,1989
(in Russian)
USSR
not
reported
Omelianchik
et al., 1993
(in Russian)
Russia, SPB
not
reported
Pugach,
2012 (in
Russian)
Russia, SPB
not
reported
Shabanov et
al., 2012 (in
Russian)
Russia, SPB
not
reported
To study the
combined effects of
alcohol and stress in
prenatal period on
adults.
To investigate the
correcting effect of
Dalargin on the CNS
of rats, who had
antenatal alcohol
intoxication.
To study the
proportional skeletal
ossification during
intrauterine
development of the
fetus to different
modes of
alcoholization.
To explore the pattern
of prenatal alcohol
exposure in newborn
rats with respect to
the immunomorphological aspect
depending on
duration of F
intoxication before
pregnancy.
To simultaneous
study the content of
main mediators of the
monaminergic system
of the brain, their
metabolites, catecholO-methyltransferase
activity and the
Sample
Dalargin; 2) injected
normal saline.
There is no selection
method described. F
mice were given 11%
ethanol solution during
1-21 days of gestation.
200 F rats. Group
1control, ; 2 born from
F, consuming 15%
ethanol solution
throughout pregnancy;
3 from 16-20 days of
pregnancy were
subcutaneously injected
15 mkg/kg of Dalargin.
264 rats: 100 control
group, 164 antenatal
alcohol offspring, and
1290 fetuses.
Findings
Parental stress and alcohol exposure affects behavior of the offspring and this
could contribute to a predisposition for obsessive-compulsive disorder. Effects
of those factors do not significantly influence motor function and
exploratory/investigative behavior of adult male mice.
In the group of rats taking Dalargin, there was not only a normalization of the
activity of succinate dehydrogenase, but also an even distribution of it in the
structures of the brain.
Moderate doses of ethanol consumption during pregnancy, in some cases, lead
to disproportional ossification of the fetus. The frequency and degree of the
changes depends on maternal body tolerance to alcohol. The most frequent type
of disproportional skeletal ossification is an asymmetry in the ossification of the
lower jaw.
135 mature
reproductive white
outbreed F, 7-monthold rats and 440
newborn rats.
Intrauterine and early postnatal mortality of rats, amount and body mass, as well
as the structure of thymus and mesenteric lymph nodes in the breed, developing
under prenatal alcohol intoxication can be determined by the duration of ethanol
exposure of F before pregnancy. The effect of ethanol during pregnancy on F
rats, as well as within 2 and 4 months before pregnancy, leads to a decrease in
the body weight of newborn rats; however, F who received ethanol during the 3
and 5 months before pregnancy have offspring with body weights that are more
than the control group.
not reported
Injecting alcohol in rats during pregnancy decreases the activity of
monoaminergic systems of the brain, which would manifest as a decrease of
noradrenaline and dopamine levels in the fetus.
21
Reference
Country, City
Year of
study
Shilko et al.,
2009a,b,
2010a,c,
2011b,c (6
publications;
in Russian)
Russia,
Yekaterinburg
not
reported
Skalny et al.,
2001 (in
Russian)
Russia,
Moscow
not
reported
Skalny et al.,
2009 (in
Russian)
Russia, SPB,
Yakutsk,
Moscow;
USA, Davis,
San Diego
(California)
not
reported
Purpose of the study
condition of subtypes
of dopamine receptors
(D1,D2S, D2L, D4,
and D5) in
developing brains of
rats, who were born
to rats alcoholized
during pregnancy and
breastfeeding.
To evaluate the
intrauterine effects of
alcohol on the
development of the
cytomorphological
structure of the CNS
in experimental
animals and to
compare TGF-β1
concentration in
animals that
consumed and did not
consume alcohol
during pregnancy.
To study the
elemental content and
activity of
acetaldehyde in the
liver of offspring of
reproductive age rats,
which were
alcoholized before
pregnancy. Also,
there was an attempt
to correct abnormal
findings with zinc
sulphate.
To study the
influence of Zn intake
before alcohol intake.
Sample
Findings
26 Wistar rats (1-2
months). Group 1
(N=13): rats that
received a 15% ethanol
solution instead of
water beginning in the
month prior to
pregnancy, and
throughout the entire
pregnancy. Group 2
(N=13): intact rats.
A strong influence of alcohol on the brain cells of the alcohol-treated animals
was documented: unloading of neurons and their dystrophic changes in the form
of pyknotic abnormalities and chromatolysis in the cortex, hypothalamus and
cerebellum. The experimental group expressed morphological changes in the
form of abnormalities in cell distribution. Also, a dystrophic appearance in
neurons of different functional structures was elicited. Statistically significant
differences in the import of TGF-β1 were identified: in the experimental group
187.9 ng/ml, in the control group 129.7 ng/mg (t - 2.68, p 0.02). The observed
increase of ТGF-β1 in pregnant alcohol-treated rats provides evidence for a
defective structure in targeting cells' receptors in F animals and in breed
offspring.
23 M rats, whose
mothers received 15%
ethanol solution as the
only source of liquid
during 20 days preconception. Then, the
M were divided into 2
groups, depending on
what fluid their
mothers were given 46
days post conception (
6 water, 7 0.2 mM Zn
sulphate, 10 controls.
Not reported.
It was shown that the offspring of rats submitted to alcohol intoxication before
the pregnancy had a high level of Cu, Mo and Se in the liver mitochondria and a
low level of Ca, Zn in liver supernatant homogenate. The addition of zinc
sulfate to the rat’s diet (0.5-0.7 mg/kg/day) during pregnancy and lactation
resulted in further elevation of Mo content as well as normalization of the other
trace element content. The data obtained showed the possibility of ethanol and
acetaldehyde metabolism regulation by means of regulation of zinc content in
the diet.
Teratogenicity of alcohol increases when there is a Zn deficit. Intake of Zn after
intake of alcohol decreases alcohol's teratogenic effect on the developing fetus
(as studied in rodents and primates).
22
Reference
Country, City
Skosyreva,
1973 (in
Russian)
USSR,
Moscow
Year of
study
not
reported
Purpose of the study
Sample
Findings
To study the direct
and indirect effects of
alcohol on the
development of
embryos in stages of
organogenesis.
Three experiments: 1)
13 rats and 103 fetuses,
2) 144 embryos, and 3)
10 rats and 135 fetuses.
1) Five ml/kg ethyl alcohol (40%) injected into pregnant rats during
organogenesis slows down the fetal development and leads to significant
increases of the intrauterine activity. 2) Direct effects of 0.5mg/ml of alcohol
and above are associated with embryo toxic reaction, which manifests as a
somite formation retardation, suppression of cardiac activity of the embryo,
allantois immaturity, and fetal death. 3) Toxic effects of alcohol are nonspecific
and can be determined by the concentration of it in the cultivation environment.
The impairing effects of ethanol on fetal development manifests in doses that
are close to those that are in people with moderate alcohol intoxication, and
manifests in increased frequency of intrauterine death and fetal development
disturbance. The toxic effect of ethanol on the embryonic development is most
pronounced during organogenesis. Injection of ethanol during fetal period of
pregnancy (12-40 week of pregnancy) does not increase the frequency of fetal
intrauterine death, but will lead to developmental delay and coexisting
anomalies of the brain/heart 4. Ethanol injection during the entire pregnancy
will increase intrauterine death, but it will affect physical development less. For
the offspring, it is dangerous to be exposed to alcohol during the early, as well
as the late stages of pregnancy, even in moderate amounts.
Prenatal chronic ethanol intoxication causes significant damaging effects on the
organism's development. Size changes of the glomerular and the tubular
apparatus of nephrons were detected, mirroring the changes in filtering and
reabsorbing capacity of the kidney and a disturbance of nephrogenesis. Intake of
a vitamin and antioxidant complex shows a well-known protective effect, as
morphological and morphometrical studies show, but it does not prevent
development of stable structural changes and disturbances of ontogenesis.
Skosyreva et
al., 1973 (in
Russian)
USSR,
Moscow
not
reported
To study the indirect
(through mother)
effects of ethanol on
fetal development
during different
periods of intrauterine
development.
Three groups of white
rats: 1) receiving
ethanol from 14th to
30th day of pregnancy,
2) receiving ethanol
from 1st to 20th day of
pregnancy, 3) receiving
ethanol during entire
pregnancy.
Sverdlova,
2008 (in
Russian)
Russia, Omsk
not
reported
68 white F laboratory
rats and 298 offspring
in the 15th day of
postnatal ontogenesis.
Vyatchanina
and Skalny,,
2009 (in
Russian)
Russia,
Moscow, SPB
not
reported
To detect the effects
of prenatal chronic
ethanol intoxication
of rats on the
development of the
breed through the
(e.g., nephrogenesis)
and to provide a
rationale for the
protective effect of
antioxidants.
To study the
influence of maternal
alcohol consumption
before pregnancy on
elemental
composition of the
cortex of the rat.
Possibilities of
correction in the
metabolism of macroand micro-elements
of zinc sulfate were
explored.
23 M white rats were
divided into 3 groups.
Group 1, 6: mothers
received a 15% ethanol
solution as the only
source of liquid for 20
days and then water the
day before mating with
an intact M. Group 2,
7: mothers received
ethanol and the day
before mating Zn
sulfate, Group 3, 10:
Alcohol intoxication of the mother before pregnancy has an impact on the
metabolism of macro- and micro-elements in the cortex. The changes in the
fetal brain are a marker for all changes in the active developing organism.
Maternal intoxication causes a misbalance of chemical elements in the breed's
brain structure. A reliable decrease not only in the macro-elements K, Na and
Mg was detected, but also in the most important micro-elements Fe and Zn,
under the influence of maternal intoxication before pregnancy. The imbalance
of chemical elements can be corrected to a great degree with Zn sulfate.
23
Reference
Country, City
Year of
study
Purpose of the study
Zabludovsky
et al., 1989
(in Russian)
USSR
not
reported
To determine
indicators of
spontaneous behavior
and reflexes of adult
rats, influenced by
varying doses of
alcohol in prenatal
period.
Zhulin and
Bazyan,
1989 (in
Russian)
USSR
not
reported
To study prenatal
ethanol influence on
intensity and stability
of
autoadrenoreceptors.
Studies on Human Biological Material (6)
Kovetcky et
USSR, Tomsk 1984To study human
al., 1991a (in
1989
embryo’s brain
Russian)
development
Kovetcky et
al., 1991b
(in Russian)
Russia
not
reported
Kuteneva et
al., 2005 (in
Russian)
Russia, Tomsk
not
reported
To compare synaptic
contact formation in
embryo's brains,
which are developing
in healthy and
diseased F.
To gather a computer
and morphometric
estimate of alcohol’s
effect on condition,
quantity, and space,
Sample
control group.
420 white rats.
2 groups: 1) F 5-20
days of gestation were
given 3-5 g/ kg/day. 2)
F, 3 weeks before
conception: 10%
ethanol, from 5-20 days
of pregnancy: 5%
ethanol and daily:4.5
g/kg 40% intragastric
ethanol. Control group
received intragastric
dextrose solution (day
5- 20 of pregnancy).
F white rats from 5- 20
days of gestation were
given intragastric 22.5ml of 40% ethanol
5X/week and a control
group.
60 embryos (5-12
weeks), 1 fetus (12
weeks). 44 embryos
and 1 fetus from
alcoholic W, with PAE.
16 embryos from
healthy W, no PAE or
exposure 6 months
before pregnancy.
10 embryos from
chronic alcoholic W
(19- 40); 20 embryos 712 weeks, from
medical abortions from
healthy W (19- 40).
11 embryos, taken from
W consuming alcohol
in early stages of
pregnancy and 12
embryos from
Findings
Sensitivity to seizure agents (electric bell, cortisol injection) increased in rats
that were influenced by ethanol during embryogenesis: there is different
sensitivity to seizure agents and there is a dose-dependent effect of ethanol and
sex predominance.
PAE leads to qualitative changes of the audrenoreceptor's activity, their function
disturbance, and their inadequate reaction. These reactions prevent formation of
specific neurological net, leading to difficulties with reflexes.
When W consume alcohol during pregnancy, their embryo may develop many
different deviations in fetal brain development. This makes it necessary to hold
prophylactic educational work amongst reproductive W with emphasis on
complete exclusion of alcoholic drinks during pregnancy.
There is synaptic immaturity seen in 12-week-old embryos with PAE, compared
to the control group. It significantly affects formation on neuronal mechanisms
responsible for taking and processing information. This negatively affects
psychiatric functions in the individual who is born to an alcoholic mother.
In embryos taken from W who consumed alcohol during different periods of
pregnancy, widening and thinning of capillary walls are observed, and the
erythrocytes in those vessels are absent. In some separately taken vessels, the
capillary wall is thickened, erythrocyte stasis is seen, which resembles
thrombosis. The size of the surface area of vessels is significantly decreased.
24
Reference
Country, City
Year of
study
Shushpanova
and
Solonsky,
2012 (in
Russian)
Russia
not
reported
Solonsky,
2008 (in
Russian)
Russia, Tomsk
not
reported
Solonsky,
2006,
Solonsky
and
Logvinov,
2008 (2
publications;
in Russian)
Russia, Tomsk
not
reported
Purpose of the study
obtained by brain
vessels in embryos of
7-12 weeks of
intrauterine
development.
To study the synaptic
connections and
benzodiazepine
receptor development
in embryonic and
fetal brain (8-15
weeks of pregnancy),
among alcoholic F.
To study the common
factors and
morphological
peculiarities of
maternal alcohol
consumption effects
on neurons and glial
cells and to study the
effects on neocortical
morphometric
parameters of blood
vessels and synaptic
contacts of embryos
and fetuses.
To study prenatal
alcohol intoxication
effects on the
developing brain
cortex vessels of the
human embryo. To
detect specific
characteristics of
synaptogenesis in the
embryonic and the
PAE fetal brain.
Sample
Findings
relatively healthy
pregnancies.
The most significant changes are seen in 11-12 weeks of intrauterine fetal
development.
Biomaterial from 33 W
with second stage
alcoholism and from 30
healthy W (control).
With PAE, the formation of synaptic benzodiazepine receptors slows down and
increases in its density.
53 embryos in 7-12
weeks of development:
23 embryos were
received from W, who
chose to terminate their
pregnancies, who
consumed alcohol
during pregnancy, and
were suffering from
alcoholism of 1-3
stages (ICD-10 codes F
10.201 and F 10.202),
and 30 embryos
(control group)
received from mentally
/physically healthy F.
53 embryos (7-12
weeks): 23 from
alcoholic W, 30 from
healthy W (control
group). Alcoholic W’s
age was 26-29;
duration of alcohol
abuse was 3-13 years.
Alcohol consumption during pregnancy causes dysontogenesis of the cortical
plate in 9-12 weeks old embryos. Prenatal influence of alcohol on the brain
caused a complex ultrastructural change, including functional and proliferative
changes, as well as elements of crash development. Manifestations of the
damaging effects of alcohol on the ultrastructure of brain cells in the period of
their ongoing differentiation was detected, which is the structural base of
morphogenesis, abnormalities of brain structures and different kinds of
abnormalities. These abnormalities determine future mental development
disorders and future behaviors of the patient.
Alcohol consumption during pregnancy influences the dynamics of fetal brain
vessel development. The characteristics of vascularization in the alcohol
exposed fetal brain are probably a result of chronic hypoxia and the mean of its
compensation. Alcohol affects synaptic development as a decrease in the
surface area of the presynaptic membrane, which decreases its ability of
conducting impulses. These all affect the mental functioning of exposed
individuals.
25
Ca: Calcium; CIS: Commonwealth of Independent States; CNS: Central Nervous System; Co: Cobalt; Cu: Copper; EE: Eastern Europe; EEG:
Electroencephalography; F: Females; FAS: Fetal Alcohol Syndrome; FASD: Fetal Alcohol Spectrum Disorder; Fe: Iron; FRUASG: Friends of Russia
and Ukrain Adoption Support Group; FSU: Former Soviet Union; hrs: hours; I: Iodine; ICD: International Classification of Diseases; K: Potassium; Mg:
Magnesium; Mo: Molybdenum; Na: Sodium; ND: Neurodevelopmental; Ni: Nickel; NNR: Nizhny Novgorod region; Ob/Gyns: Obstetricians and
Gynaecologists; P: Phosphorus; PAE: Prenatal Alcohol Exposure; Pb: Lead; Se: Selenium; PW: Pregnant women; SPB: Saint Petersburg; Sr: Strontium;
TGF-β1: Transforming Growth Factor -β1; USA: United States of America; W: women; Zn: Zinc
Note 1: Articles published in iteration are excluded from the total reported number of studies.
Note 2: In cases where the article did not define heavy drinker, binge drinking, abuse and/or dependence, definitions were not provided in the table.
26